UTAH DEPARTMENT OF WORKFORCE SERVICES
|DWS-OSD 59 |State of Utah | |
|Rev. 02/2009 |Department of Workforce Services | |
| |JOB ORDER FORM | |
|4 Ways to Submit a JOB ORDER |
|Online: jobs. |FAX: 1-866-968-0060 |
|E-mail: postajob@ |Phone: 1-888-920-WORK (9675) |
|( EMPLOYER INFORMATION |
|COMPANY NAME: CONTACT PERSON: |
|STREET ADDRESS: |
|CITY: STATE: ZIP CODE: |
|PHONE NUMBER: ( ) - |
|FAX NUMBER: ( ) - FEDERAL ID# (FEIN): |
|EMAIL ADDRESS: UT EMPLOYER TAX ID# (UI ID): |
|FEDERAL CONTRACTOR (FCJL): Yes No AFFIRMATIVE ACTION EMPLOYER: Yes No |
|JOB SITE LOCATION: |
|( JOB TITLE: NUMBER OF OPENINGS: |
|JOB DESCRIPTION (Include tasks, duties, responsibilities): |
| |
| |
| |
|JOB DETAILS: |
|SALARY: From $ To $ (Hourly/Monthly/Yearly) BENEFITS: Yes No |
|HOURS: From (am/pm) To (am/pm) |
|SHIFTS (check all that apply): Day Swing Graveyard Rotating |
|WORK: Full-Time Part-Time Seasonal Temporary |
|DAYS OFF: Sat Sun Mon Tues Wed Thurs Fri |
|( JOB REQUIREMENTS (Must be bona fide qualifications required to perform the job.) |
|EXPERIENCE (Years/Months): AGE: to |
|IS VEHICLE REQUIRED? Yes No LIFTING (lbs.): |
|DRIVER’S LICENSE: Yes No LICENSE TYPE: A / B / C / D ENDORSEMENTS: H / N / T / X / P |
|EDUCATION: None GED HS AA BA/BS MA/MS PhD Cert./Lic. |
|COMPUTER SKILLS/KNOWLEDGE: |
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|SPECIAL MACHINERY/TOOLS/KNOWLEDGE: |
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|ADDITIONAL INFORMATION / CLOSING DATE (If applicable): |
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|REFERRAL INSTRUCTIONS (How would you like applicants to apply?): |
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|Would you like information about Tax Credits for hiring special populations? Yes No |
Equal Opportunity Employer Program
Auxiliary aids and services are available upon request to individuals with disabilities by calling (801) 526-9240. Individuals with speech and/or hearing impairments may call Relay Utah by dialing 711. Spanish Relay Utah: 1-888-346-3162
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